Medicine In The Third Reich

Question 1

What were the material and intellectual considerations that prompted on their part such a high degree of complicity in Hitler’s pursuit of ‘racial community’ (Volksgemeinschaft)?

Answer 1

The idea of racial superiority grew in stature from the mid 19th century through to the rise of Nazism, with doctors often lending their authority.
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By 1936 half of Germany’s non-Jewish doctors had become members of the Nazi party.
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Opportunism – public funding for health was at low levels, too many graduating doctors for too few jobs, private practice profits dropped.
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Hitler promised economic recovery
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Constructive aspects of Nazi health policy
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Continuation of Weimar Welfare policy
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Enlargement of professional infrastructures – research centres and journals
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From 1933-39, cancer care, PH, dentistry, midwifery etc. all improved!
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Promotion of community medicine – however a tight racial ring around who received treatment
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Nazis didn’t misrepresent science – racial superiority was a concept initiated by the days scientists and doctors
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Claimed that those who were not Aryan were disrupting the pursuit of biological perfection

Question 2

How was the Nazi philosophy of medicine converted into action, with particular reference to enforced sterilisation and involuntary ‘euthanasia’, and to the pursuit of inhuman scientific experimentation and ultimately even of genocide?

Answer 2

 In 1933 genetic health courts were set up, each run by a lawyer and 2 doctors. The proceedings were secret. They were set up by the “Law for the prevention of hereditarily diseased progeny”
 Courts could subpoena private medical records
 Effectively turned doctors into state spies expected to report candidates for sterilization
 Over 70% of candidates had “congenital feeble mindedness” or Schizophrenia
 Law later expanded to include “dangerous habitual criminals”, and allow abortion up to six months for mothers with hereditary illnesses.
 Men had vasectomies, women tubes ligated, or later X-ray irradiation. 400,000 sterilizations pre-war.
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Most of those sterilized were Germans, housed in asylums
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Argument was made not just on eugenic grounds, but economic too
 Sufferers of chronic mental/physical illness were beings of lesser worth, and greater cost to the state.
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This set the grounds for “mercy-death” imposition upon sufferers of incurable illness. From 1939-41, there were 70,000 mercy deaths. This was phase one = Aktion T4
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Phase two, from August 1941-1945 killed nearly 140,000
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Aktion T4
 Centralised in Berlin, directions of victims to six major killing asylums
 Started with congenitally deformed children, lethal injection or calculated starvation
 Moved onto adults by early 1940, and CO poisoning was used
 Many doctors knew where their patients were being sent to with regard to the asylums
 About half of victims had started off in ecclesiastically run institutions
 Public knew about it, even family members, but felt it was for the greater good
 Public protest in 1941 from Catholic bishop – by then most of its aims had been achieved
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From Aug 1941
 Process decentralised
 It was now routine for people to undergo involuntary euthanasia at dozens of hospitals, with dozens of doctors and nurses complicit
 Ailing imported workers and “aliens to the community” were added to list
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Aktion14F13
 Stage two
 Hundreds of doctors involved in Aktion T4 were moved to Aktion14F13
• This involved providing medical confirmation for culling those in concentration camps that the SS said were too sick for labour
• In Russia, doctors supervised the shooting of the mentally unwell in soviet territory
 Issues of illness were entwined with allegations of moral depravity and racial inferiority
 Killing became routinized
 Killing in name of racial hygiene became rationalized and regarded as healing – preserving the health of the Aryan race
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Dr Josef Mengele
 Connection between Euthanasia, Genocide and Experimentation
 Those determined for death could prove useful as tools on which to experiment on
 Twins ideal, as they made good controls for one another
 Could find out how the Reich could eventually produce multiple Aryan births
 Other institutions could exploit the material for their own use
• “wonderful material amongst those brains… where they came from, and how they came to me, was really none of my business”
• Medical students continued using the collections for approx. 40 years

Question 3

What rationalisations of such conduct were offered in defence or mitigation when a limited selection of doctors were put on trial in 1946-, and what significance should we attach to the ‘Nuremberg Code’ of medico-experimental ethics that was generated out of those criminal proceedings?

Answer 3

 Charged with War Crimes, and Crimes against Humanity
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Defences offered
- Necessities of the war emergency
- Unquestionable authority of the state
- Binding “superior” orders
- Defensibility of actions taken in accordance with German law at the time
- The defence that they merely acted as technicians
- They were unaware of the systematic murderous regime as a whole
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Medically specific defences
- USA doctors had experimented on criminals with doubtful consent
- Absence of universal norms for research ethics
- If the doctors did not do the experiments, someone else would have done them in a less humane manner
- Intrinsic scientific value of the experiments which outweighed the harm done, in the name of the greater good

Question 4

Why, and with what degree of success, did the post-war West German medical establishment attempt to distort the historical record as part of a comprehensive ‘cover up’?

Answer 4

45% of doctors were members of the Nazi party, very few anti-fascist refugee doctors returned to Germany
- As a result, there were few antifascist voices within the profession.

Two post-war presidents of the West German Chambers of Physicians were former SS members. Dr Hans Joachim Sewering, the last president, was forced to resign but remained president of the Bavarian Chamber of Physicians.

Example of Dr Heyde – he was a director of the Aktion T4 programme. He practiced medicine under a false name for 14 years and his identity was concealed by the whole local medical establishment. He was employed by the state to given expert testimony in disablement and compensation claims of Nazi victims.
- When his identity was uncovered and he was prosecuted, the prosecutor tried to uncover and indict other members of the T4 establishment. They tried to break Heyde out of prison. Heyde then committed suicide.

It was not until late 1980s that all specimens of Nazi victims were removed from academic institutions. They came under pressure having used the specimens in research that was then presented abroad.

The Gesundheitstag, was held in West Berlin in May, 1980. This was a counter-conference to the West German chambers of physicians was held as the host of the WGC was a former SA member.
- This conference invited Jewish doctors from abroad and encouraged the study of the Nazi scientists methods and crimes